Adverse Effects of a Kenalog Injection

Patricia Nevins, RN, MSN

About the Author:

Patricia Nevins, RN, MSN

Patricia Nevins is a registered nurse with nearly 20 years of nursing experience. She obtained her Master of Science in nursing with a focus in education from the University of Phoenix. Nevins shares her passion for healthy living through her roles as educator, nursing consultant and writer.

Kenalog for injection comes in two forms, one as triamcinolone acetonide, which is used for intra-articular (into the joint) injection, and the other as triamcinolone diacetate which is given as an intramuscular injection. Kenalog is a synthetic corticosteroid used as an anti-inflammatory and immunosuppressant. Kenalog injection is effective in treating conditions such as rheumatoid arthritis, acute gouty arthritis, osteoarthritis and bursitis. Severity of adverse reactions is dose dependent.

Central Nervous System Side Effects

Kenalog may cause headache, fatigue, dizziness, insomnia and confusion in some patients. Euphoria and psychosis have also been reported. Patients should see a physician if any of these symptoms is experienced. The National Institute of Health reports that large doses of corticosteroids such as Kenalog injection used in patients with a history of neuromuscular disorders or in conjunction with neuromuscular blockers may lead to an acute myopathy. Myopathy symptoms are severe, involving weakness or loss of function to skeletal muscles, eye muscles and muscles involved in respiratory function.

Cardiovascular System Side Effects

An adverse side effect of Kenalog is edema (fluid retention). Patients should be instructed to weigh themselves daily to monitor for fluid retention. Kenalog should not be used, or used with caution, in patients with a history of congestive heart failure, high blood pressure or kidney failure. Kenalog may also lead to loss of sodium and potassium, which can cause muscle weakness and lethal irregular heart rhythms. Shortness of breath, palpitations and chest pain should be reported to a physician.

Endocrine System Side Effects

Long term use of a corticosteroid like Kenalog can lead to Cushingoid features; for example, moon face, buffalo hump (fatty swellings between shoulder blades) and distended abdomen. Growth retardation in children, elevated blood glucose levels, and high blood pressure may also occur. Blood glucose levels and adrenal function should be monitored throughout therapy and for several months following therapy. Kenalog injection should be discontinued slowly to avoid adrenalcortical insufficiency.

Musculoskeletal System Side Effects

Kenalog use can lead to delayed wound healing, muscle weakness and wasting, and osteoporosis. Prolonged use of a corticosteroid like Kenalog can lead to bone loss and spontaneous fractures. Easy bruising may also occur.

Gastrointestinal Side Effects

Kenalog injection can cause nausea, vomiting and gastric irritation such as peptic ulcer. Kenalog should be used with caution in patients with a history of peptic ulcer disease, diverticulitis and ulcerative colitis due to an increased risk of gastric and bowel perforation.

Dermatologic Side Effects

People taking Kenalog may experience itching and burning sensations of the skin. Folliculitis and decreased pigmentation have also been reported.